Obamacare: The Threat to Physician Autonomy (On Healthcare Reform: An M.D.'S View)

The debate raging over ObamaCare has been carried on mostly by politicians, pundits, policy wonks and economists, with little input from those most intimately involved with delivery of health care--medical practitioners. Doctors have too often been marginalized as self-interested. If that were true, there would be far fewer practicing physicians. Of course we are concerned with income, as are all taxpayers and businesses faced with rising costs and taxes. Unlike other businesses, however, most doctors are unable to pass higher costs to consumers due to price controls on reimbursement. When costs outpace income, bankruptcy ensues. This renders discussions of autonomy moot. Autonomy, for physician and patient, is central to the medical profession and dates back to Hippocrates: "I will prescribe regimen for the good of my patients according to my ability and my judgment. I will keep them from harm and injustice."